School health services is a branch of preventive medicine which deals with medical inspection of school children and their health protection, primarily in the environment of the school.

1. AB RAJAR
ASSOCIATE PROFESSOR
COMMUNITY MEDICNE
MUHAMMAD MEDICAL COLLEGE.MPK

2. • Introduction.
• Definition.
• Aims & objectives
• School health team
• Aspects of school health services
• Duties of school health team
• Types of desks.
• School health problems

3. • An important branch of community health.
• According to modern concepts, school health service is an economical and
powerful means of raising community health, and more important, in future
generations.
• The school health service is a personal health service.
• It has developed during the past 70 years from the narrower concept of
medical examination of children to the present-day broader concept of
comprehensive care of the health and well-being of children throughout
the school years.

4. .
• SCHOOL HEALTH SERVICES:
• School health services is a branch of preventive medicine which deals
with medical inspection of school children and their health
protection, primarily in the environment of the school.

5. • School health refers to a state of complete physical, mental, social
and spiritual well being and not merely the absence of disease or
infirmity among pupils, teachers and other school personnel. [k. k.
gilani].
• DEFINITION OF SCHOOL HEALTH SERVICES:
• School health service refers to need based comprehensive service
rendered to pupils, teachers and other personnel in the school to
promote, protect their health, prevent and control disease and
maintain their health.[- k. k. gulani]

6. • School children constitute a vital and substantial segment of population.
• Schoolchildren are vulnerable section of population by virtue of their
physical, mental, emotional and social growth and development during this
period.
• School children are expressed to various stressful situations.
• Children coming to school belong to different socio economic and cultural
background which affect their health and nutritional status and require
help and guidance in promoting, protecting and maintaining their health
and nutritional status.
• Children in school age are prone to get specific health problems.

7. • Promotion of positive health.
• Early detection of defects through a program of periodical medical
check-up of children.
• Treatment & follow-up of defects.
• Minimization of chances of spread of communicable diseases.
• Awakening health consciousness in school children.
• Teaching of the staff of school to detect defects.
• Provision of healthy environment.

8. • To prepare the younger generation to adopt measures to remain
healthy so as to help them to make the best use of educational
facilities, to utilize leisure in productive and constructive manner, to
enjoy recreation and to develop concern for others.
• To help the younger generation become healthy and useful citizen
who will be able to perform their role effectively for the welfare of
themselves, their families and the community at large and country as
a whole.

9. • The school health team in a whole-time medical service consists of:
• School Medical Officer.
• Public Health Officer.
• Attendant.
• This team is located in one of the largest school & is for 3000 – 5000
children.

10. 1. Health appraisal of school children and school personnel.
2. Remedial measures and follow up.
3. Prevention of communicable disease.
4. Healthful school environment.
5. Nutritional service.
6. First aid and emergency care.
7. Mental health

11. • PERIODICAL MEDICAL EXAMINATION:
• Medical examination on entry- 4 years.
• Routine physical examination needs to be done.
• Clinical examination for nutritional deficiency, examination of faeces.
• Tuberculin testing/ Testing of vision, regular and quarterly wt/ht checking.
• DAILY MORNING INSPECTION BY THE TEACHERS:
• Inspection of rashes, spots, signs of acute cold, coughing and sneezing, sore
throat, rigid neck, nausea, vomiting, watery eyes, headache, chills, fever, etc.
• MEDICAL EXAMINATION OF SCHOOL PERSONNEL:
• Staff form part of the school environment.

12. • Diseased children are treated at primary health centers.

13. • Clean environment,saniatary conditions and good hygiene prevent
spread of communicable diseases.
• Immunization of children.

14. • A. Location of School.
• Proper approach with wide road.
• Fair distance from busy places.
• Premises are fenced and kept free from all hazards.
• B. Site:
• High land with proper drainage.
• C Structure:
• Nursery and secondary schools must be single stored.
• D. Class rooms.
• Verandas attached to classrooms.
• Each classroom should accommodate not more than 40 students.
• Rooms with sufficient lighting and ventilation.

15. • E. Furniture:
• Negative desks are recommended.
• F. Door and Windows:
• Windows 2 feet 6” above floor level.
• Window and door area should be at least 25% of the floor area.
• Cross ventilation ensured.
• G. Water supply.
• Continous,distribution through taps.
• H. Eating facility:
• Separate room for mid-day meals.

16. • Good nutrition is very essential not only for optimal health growth
and development of the school child but also for his/her educational
achievement.
• A nutritious mid-day meal for children in the school is considered as a
practical solution to combat malnutrition in children.

17. • Facility available within school.
• Dispensary in school.
• Facilities for managing accident and medical emergencies like
gastroenteritis, fainting, epileptic fits etc.

18. • School teacher plays both a positive and preventive role.
• Help and counsel the students.
• There is increased need of psychologists and vocational counselors in
school for guiding children about career planning.

19. • School children usually suffer from dental diseases and defects.
• School health should incorporate dental health components too.
• Dental hygienist and dentist are to be employed.
• During the dental check up should focus on prophylactic cleansing
and dental hygiene classes.

20. • Teachers are in key position to detect reflective errors, refer for
treatment for squints, amblyopia and to detect eye infections.
• Vitamin A administration could be done.

21. • School teacher is key person for health education.
• Personal hygiene of skin,teeth,hair and refraction of errors.

22. • Every child irrespective of the disability, should be encouraged to
become productive and self supporting.

23. • Such record must contain identity, past health history and record of
findings of physical examination and screening tests.
• Help in evaluating school health program.

24. • Any discussion of a school health service must be based on:
1. The local health problems of the school child,
2. The culture of the community and
3. The available resources in terms of money, material and
manpower.
4. While the health problems of school children vary from one
place to another, surveys indicate that the main emphasis will fall
in the following categories.

25. 1. Dental problems
2. Malnutrition
3. Infectious diseases/Communicable diseases
4. Parasitic infestations
5. Lice infestation
6. Diseases of skin
7. Diseases of eye
8. Diseases of ear
9. Congenital abnormalities
10. Psychological problems

26. 1. Dental problems: Dental caries, fluorosis, gingivitis
2. Malnutrition: Stunting, anemia, Vit.A deficiency, obesity
3. Infectious diseases/Communicable diseases:
• Measles, mumps, rubella, chicken pox, whooping cough, acute tonsillitis, pneumonia,
etc.
1. Parasitic infestations: Hook worm, round worm, pin worm
2. Lice infestation
3. Diseases of skin: Scabies, fungal infections
4. Diseases of eye : Poor eyesight, color blindness
5. Diseases of ear: Acute or chronic OM, ear wax, earache
6. Congenital abnormalities: Cleft of lip/palate
7. Psychological problems
8. Injuries/falls: Major/minor

27. PSYCHOSOCIAL SCHOOL HEALTH PROBLEMS
• BEHAVIOR PROBLEM:
• 1. ANTISOCIAL PROBLEM: -
• Stealing,
• Lying,
• Gambling,
• Destructiveness, sexual offence.
• 2. HABIT DISORDERS: -
• Nail biting,
• Thumb sucking,
• Bed wetting.

28. PSYCHOSOCIAL SCHOOL HEALTH PROBLEMS
• BEHAVIOR PROBLEM:
• 3.PERSONALITY DISORDERS: -
• Temper tantrum,
• Shyness,
• Say dreaming,
• and jealousy.
• 4. EDUCATIONAL DIFFICULTIES: -
• Backwardness in study,
• School fear,
• School failure, etc.

29. • The school principal.
• The school teacher.
• The parents.
• The community.
• The children.
• The medical officer.
• The school health nurse/ community health nurse

31. Duties Of A School Medical Officer[MO]
1. Preparation and maintenance of health record of all the children/teachers and other
staff.
2. Routine medical inspection of children/teachers.
3. Treatment of common aliments/injuries.
4. Referral (if required) and follow up of cases.
5. Health education and training in first aid.
6. Coordination for physical education
7. Inspection of class rooms, canteen, wash rooms, playground, hostels, offices, etc. The
aim is to inspect:
1. Seating arrangements
2. Lighting, ventilation, heating, cooling facilities
3. Waste disposal system
4. Drinking water facility
8. Meeting with the administration and parents (if required).

32. Comprehensive Medical Examination

33. • She should be qualified in public health nursing.
• Assisting MO in his/her duties and examination.
• Record keeping.
• Supervising the health habits of all the school children.
• Update MO about progress of children health.
• If required, she pay home visits.
• Treat minor ailments.
• Attend conferences of doctors and nurses.

35. • There are three types of desks:
1. POSITIVE OR PLUS DESK:
• A vertical line drawn from the edge of desk falls outside the edge of chair.
2. ZERO OR MINUS DESK:
• A vertical line drawn from the edge of desk touches the edge of the chair .
3.NEGATIVE OR MINUS DESK:
• A vertical line drawn from the edge of desk falls on the seat.
• Note: Minus desks are the best and preferred.

36. Types of desks.

37. Types of desks (Cont….)
 What is a minus desk?
• A vertical line drawn from the edge of the desk falls on the seat.
 What is a zero desk?
• A vertical line drawn from the edge of the desk
touches the edge of the seat.
 What is a plus desk?
• A vertical line drawn from the edge of the desk falls outside the edge of the
seat.

38. Desks recommended for school children.
• Minus or Zero desks are recommended for school.
• Minus or zero desk will enable the student
• To keep the proper distance from the desk to his eyes
• and also avoid postural deformities.(Kyphosis and Scoliosis).

39. THANK YOU..!!